Late Stage and Grave Prognosis of Esophageal Cancer in Thailand

Abstract

<b>Background:</b> Esophageal cancer is one of the major health concerns in Southeast Asian countries, includingThailand. However, only a limited number of studies have been reported from this region. This study wasdesigned to evaluate the prevalence, clinical characteristics and survival rate of esophageal cancer in Thailand.Materials and <br/><b>Methods</b>: Clinical information, histological features and endoscopic findings were collected froma tertiary care center in central region of Thailand between September 2011- November 2014 and reviewed.<br/><b>Results</b>: A total of 64 esophageal cancer patients including 58 men and 6 women with mean age of 62.6 yearswere enrolled. Common presenting symptoms were dysphagia (74%), dyspepsia (10%) and hematemesis (8%).Mean duration of symptoms prior to diagnosis was 72 days. Esophageal stenosis with contact bleeding was themost common endoscopic finding (55.6%). The location of cancer was found in proximal (16%), middle (50%)and distal (34%) esophagus. Squamous cell carcinoma was far more common histology than adenocarcinoma(84.2% vs 10.5%). However, esophageal adenocarcinoma was significantly more common than squamous cellcarcinoma in distal area of esophagus (100% vs 22.9%; p=0.0001, OR=1.6, 95%CI=1.1-2.2). Esophageal cancerstages 3 and 4 accounted for 35.2% and 59.3% respectively. Overall 2-year survival rate was 20% and only 16%in metastatic patients. <br/><b>Conclusions</b>: Most esophageal cancer patients in Thailand have squamous cell carcinomaand nearly all present at advanced stage with a grave prognosis. Screening of high risk individuals and earlydetection might be important keys to improve the survival rate and treatment outcome in Thailand.